Care requires Trust before Task

Undoubtedly, the most difficult kind of senior care is when our loved one is living with dementia. Changes in the brain that destroy their physical and cognitive abilities, but leave their emotions intact, create unique and difficult challenges that cannot be overcome with conversation, logic, or explanation, which we commonly use when caring for seniors not living with dementia.

Compassionate and effective care under any circumstances requires cooperation, but too often we are not taught this. We are taught that care is a task, or a series of tasks that are, admittedly, not easy. Showering, changing a brief, lifting or moving a person, grooming, or assisting with eating; none of these is easy!

It does not help matters that in professional care facilities the staff may be overworked. Understandably, it is difficult to take extra time to establish a relationship with a resident when you know there are a dozen more down the hall who also require your attention. This pressure to perform tends to make us focus on the task rather than the relationship.
In my opinion, training for professional care often focuses too much on the techniques of performing a task rather than building a relationship and establishing trust to facilitate the task.
What is really different between “task” and “trust” is that we must perform tasks again and again and again, sometimes to the point of exhaustion. The tasks of personal care are never-ending, time consuming, and debilitating.

Trust, however, we need to establish only once. And once it is established, it can be maintained through simple practices of compassion, a smile, a kind word, and appropriate touch. With a relationship of trust, the tasks become quicker and easier.

For our loved ones living with dementia, trust cannot be established simply through conversation. Logic, explanation, lots of words, and arguments won’t work for them. Our usual verbal methods of communication can often make the situation worse by creating fear and confusion. This erodes trust.

Our loved ones living with dementia can still learn on an emotional level. Their feelings are still intact, and by working through feelings we can establish trust and even help them learn new habits and routines that will facilitate their own care. This is the core philosophy that I teach in all of my workshops and in my counseling with families living with dementia.
Through techniques of voice, approach, and appropriate touch, we can build a relationship that treats our loved one as a care partner, not a care task. With the use of Hand-under-hand® methodology, a key feature of Teepa Snow’s Positive Approach to Care, we can actually share the tasks of care with our loved one, which protects their dignity and strengthens the bond of trust.

I believe these understandings are so essential for effective dementia care that we have recently incorporated a new slogan in our writings and workshops: “Trust before task.” This is the cornerstone of building a relationship that benefits both partners in the responsibility of care.

And the cool thing about the “Trust before task” concept is that it is not just something that applies in dementia care. Trust before task is beneficial for all types of senior care. But for dementia care it is essential.

Finally, the most important reason we should put trust before task is . . . we all deserve the best!

Until next time remember: “We all deserve the Best”
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